Provider Demographics
NPI:1063039998
Name:SIMMONS GARVIN, TAMEKA
Entity type:Individual
Prefix:MRS
First Name:TAMEKA
Middle Name:
Last Name:SIMMONS GARVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4035 KESSLER AVE APT 1506
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31408-2626
Mailing Address - Country:US
Mailing Address - Phone:912-312-5952
Mailing Address - Fax:
Practice Address - Street 1:945 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1604
Practice Address - Country:US
Practice Address - Phone:516-206-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician